NCPA - National Center for Policy Analysis

A Cheap, Simple, Lifesaving Technology Is Not Widely Used

March 23, 2001

"A simple $100 procedure can make the difference between life and death for people with severe head injuries," says the Wall Street Journal, "but most of the nation's trauma hospitals don't use it."

By drilling a small hole in the skull of head trauma injury patients, doctors can insert a tube to monitor brain pressure and drain spinal fluid. This can prevent the brain from suffering a second injury from swelling -- which can be fatal.

Monitoring brain pressure is a key part of treatment guidelines supported by the American Association of Neurological Surgeons, the World Health Organization's head-injury committee and the American College of Surgeons. Unfortunately, most trauma hospitals don't routinely use it.

  • About 52,000 Americans die each year from traumatic brain injuries, making it the leading cause of death and disability for people ages 1 to 45.
  • An estimated 10,000 of those deaths are preventable, according to the Brain Trauma Foundation, if treatment guidelines were followed.
  • A recent survey by the Foundation in New York, however, found two-thirds of the nation's trauma hospitals don't routinely monitor brain pressure on head-injury patients, and only 85 of the 500 trauma centers -- just 17 percent -- regularly comply with all the treatment guidelines.

In fact, most head-injury patients still receive outdated treatment, such as forced hyperventilation, steroids or restricted fluids. Doctors say those treatments sometimes do more harm than good.

  • After Inova Fairfax Hospital in Falls Church, Va., adopted the guidelines, deaths due to severe head trauma fell 33 percent, according to surgeon Samir M. Fakhry, chief of trauma services.
  • The brain pressure monitoring equipment costs less than $100, but following the patient around the clock for five days is labor intensive and expensive.
  • However, monitoring reduces other costs of care -- at Fairfax, hospital charges for care dropped by 25 percent once the brain-pressure monitoring guidelines were adopted.

Source: Tara Parker-Pope, "A Simple Procedure Is Key For Head-Injury Patients," Wall Street Journal, March 23, 2001.

For text (WSJ subscribers)


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